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Anatomical Considerations of Intramedullary Humeral Nailing and Lengthening

1
Department of Orthopedics and Trauma-Surgery, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria
2
Division of Anatomy and Cell Biology, Medical University of Vienna, Währinger Straße 13, A-1090 Vienna, Austria
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(3), 806; https://doi.org/10.3390/jcm9030806
Received: 6 February 2020 / Revised: 25 February 2020 / Accepted: 4 March 2020 / Published: 16 March 2020
(This article belongs to the Section Orthopedics)
Intramedullary lengthening, in cases of extensive humeral shortening, offers the advantages of preventing external-fixator-associated problems. The humeral cavity, as the main parameter in nailing, however, has been neglected in recent literature. It was hypothesized that available implants might be too large and therefore increase the risk of intraoperative fractures. The aim of this cross-sectional study was to describe the humeral canal and how it might affect the choice of implant and the surgical approach. Thirty humeri (15 female, 15 male) from clinical patients and anatomical specimens were studied. Specifically, the medullary cavity width (MCW), cortical thickness (CoT), and the course of the medullary canal were examined. The smallest MCW diameters were found at the distal third of the humeral shaft with mean diameters of 10.15 ± 1.96 mm. CoTs of female humeri were significantly smaller than those of male humeri (p < 0.001). The mean angles of the pro- and recurvatum were 4.01 ± 1.68° and 10.03 ± 2.25°, and the mean valgus bending was 3.37 ± 1.58°. Before implanting a straight lengthening nail into a doubly curved humerus, X-rays and, in selected cases, CT-scans should be performed. The unique size and course of the humeral canal favors an antegrade approach in cases of intramedullary lengthening. View Full-Text
Keywords: humerus; intramedullary lengthening; medullary cavity; cortical thickness humerus; intramedullary lengthening; medullary cavity; cortical thickness
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MDPI and ACS Style

Schwarz, G.M.; Zak, L.; Hirtler, L.; Wozasek, G.E. Anatomical Considerations of Intramedullary Humeral Nailing and Lengthening. J. Clin. Med. 2020, 9, 806. https://doi.org/10.3390/jcm9030806

AMA Style

Schwarz GM, Zak L, Hirtler L, Wozasek GE. Anatomical Considerations of Intramedullary Humeral Nailing and Lengthening. Journal of Clinical Medicine. 2020; 9(3):806. https://doi.org/10.3390/jcm9030806

Chicago/Turabian Style

Schwarz, Gilbert M., Lukas Zak, Lena Hirtler, and Gerald E. Wozasek. 2020. "Anatomical Considerations of Intramedullary Humeral Nailing and Lengthening" Journal of Clinical Medicine 9, no. 3: 806. https://doi.org/10.3390/jcm9030806

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